Relationship between Three-year Survival and Functional Outcome at Discharge from Acute-care Hospitals in Each Subtype of First-ever Ischemic Stroke Patients

• Published in: Internal Medicine Vol. 50; no. 13; pp. 1377 - 1383
• Main Authors: Suto, Yutaka, Kowa, Hisanori, Nakayasu, Hiroyuki, Awaki, Etsuko, Saito, Jun, Irizawa, Yoshito, Nakashima, Kenji
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2011
• Subjects: activities of daily living (ADL); acute ischemic stroke; Aged; Aged, 80 and over; Brain Ischemia - diagnosis; Brain Ischemia - mortality; Brain Ischemia - physiopathology; Female; Hospitals - trends; Humans; Male; Middle Aged; Patient Discharge - trends; Prospective Studies; Recovery of Function - physiology; Stroke - mortality; Stroke - physiopathology; Survival Rate - trends; Time Factors; Treatment Outcome
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.50.4498

Background We studied the relationship between survival prognosis and the functional outcome at discharge from acute-care hospitals in each subtype of ischemic stroke patients. Methods A total of 853 consecutive patients with first-ever ischemic stroke, recruited from December 1999 to November 2002, were followed for 725.8 ± 430.0 days. Functional outcome was scored using the modified Rankin scale (mRS). Survival analysis was performed using Kaplan-Meier curves, log rank test, and Cox regression model. Results The respective mortality of the groups with mRS scores of 0-2, 3, 4, and 5 were 13.1%, 25.0%, 47.2% (p<0.05), and 74.0% (p<0.05) in cardioembolic infarction (CEI) patients; 11.3%, 6.9%, 5.6%, and 46.7% (p<0.05) in atherothrombotic infarction (ATI) patients; 8.5%, 5.6%, 11.1%, and 0% (no patient) in lacunar infarction (LACI) patients; and 2.6%, 3.0%, 23.3% (p<0.05), and 28.9% (p<0.05) in infarction of unknown cause (IUC) patients. Multi-variate analysis showed that the mRS score was a significant predictive factor for death in CEI patients, and tended to be a predictive factor for death in ATI patients, or IUC patients. Conclusion Functional outcome at discharge from acute-care hospitals may predict the survival prognosis of each subtype of ischemic stroke.